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Borrelli E, Bandello F, Boon CJF, Carelli V, Lenaers G, Reibaldi M, Sadda SR, Sadun AA, Sarraf D, Yu-Wai-Man P, Barboni P. Mitochondrial retinopathies and optic neuropathies: The impact of retinal imaging on modern understanding of pathogenesis, diagnosis, and management. Prog Retin Eye Res 2024; 101:101264. [PMID: 38703886 DOI: 10.1016/j.preteyeres.2024.101264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 03/18/2024] [Accepted: 04/26/2024] [Indexed: 05/06/2024]
Abstract
Advancements in ocular imaging have significantly broadened our comprehension of mitochondrial retinopathies and optic neuropathies by examining the structural and pathological aspects of the retina and optic nerve in these conditions. This article aims to review the prominent imaging characteristics associated with mitochondrial retinopathies and optic neuropathies, aiming to deepen our insight into their pathogenesis and clinical features. Preceding this exploration, the article provides a detailed overview of the crucial genetic and clinical features, which is essential for the proper interpretation of in vivo imaging. More importantly, we will provide a critical analysis on how these imaging modalities could serve as biomarkers for characterization and monitoring, as well as in guiding treatment decisions. However, these imaging methods have limitations, which will be discussed along with potential strategies to mitigate them. Lastly, the article will emphasize the potential advantages and future integration of imaging techniques in evaluating patients with mitochondrial eye disorders, considering the prospects of emerging gene therapies.
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Affiliation(s)
- Enrico Borrelli
- Department of Surgical Sciences, University of Turin, Turin, Italy; Department of Ophthalmology, "City of Health and Science" Hospital, Turin, Italy.
| | - Francesco Bandello
- Vita-Salute San Raffaele University, Milan, Italy; IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Camiel J F Boon
- Department of Ophthalmology, Amsterdam University Medical Centers, Amsterdam, the Netherlands; Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands
| | - Valerio Carelli
- Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna, Programma di Neurogenetica, Bologna, Italy
| | - Guy Lenaers
- Equipe MitoLab, Unité MitoVasc, INSERM U1083, Université d'Angers, 49933, Angers, France; Service de Neurologie, CHU d'Angers, 49100, Angers, France
| | - Michele Reibaldi
- Department of Surgical Sciences, University of Turin, Turin, Italy; Department of Ophthalmology, "City of Health and Science" Hospital, Turin, Italy
| | - Srinivas R Sadda
- Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Doheny Eye Institute, Los Angeles, CA, USA
| | - Alfredo A Sadun
- Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Doheny Eye Institute, Los Angeles, CA, USA
| | - David Sarraf
- Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Patrick Yu-Wai-Man
- John van Geest Centre for Brain Repair and MRC Mitochondrial Biology Unit, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK; Cambridge Eye Unit, Addenbrooke's Hospital, Cambridge University Hospitals, Cambridge, UK; Moorfields Eye Hospital NHS Foundation Trust, London, UK; Institute of Ophthalmology, University College London, London, UK
| | - Piero Barboni
- IRCCS San Raffaele Scientific Institute, Milan, Italy; Studio Oculistico d'Azeglio, Bologna, Italy.
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Delibes C, Ferré M, Rozet M, Desquiret-Dumas V, Descatha A, Gohier B, Gohier P, Amati-Bonneau P, Milea D, Reynier P. Genetic susceptibility to optic neuropathy in patients with alcohol use disorder. J Transl Med 2024; 22:495. [PMID: 38796496 PMCID: PMC11127293 DOI: 10.1186/s12967-024-05334-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 05/20/2024] [Indexed: 05/28/2024] Open
Abstract
BACKGROUND The pathophysiology of toxico-nutritional optic neuropathies remains debated, with no clear understanding of the respective roles played by the direct alcohol toxicity, smoking and the often associated vitamin deficiencies, which are risk factors for optic neuropathy. Our aim was to investigate genetic susceptibility in patients with bilateral infraclinical optic neuropathy associated with chronic alcohol use disorder. METHODS This retrospective cohort study included 102 visually asymptomatic patients with documented alcohol use disorder from a French reference center. Optic neuropathy was identified with optical coherence tomography (OCT), after which genetic susceptibility in the group of affected patients was investigated. Genetic testing was performed using panel sequencing of 87 nuclear genes and complete mitochondrial DNA sequencing. RESULTS Optic neuropathy was detected in 36% (37/102) of the included patients. Genetic testing of affected patients disclosed two patients (2/30, 6.7%) with optic neuropathy associated with pathogenic variants affecting the SPG7 gene and five patients (5/30, 16.7%) who harbored variants of uncertain significance close to probable pathogenicity in the genes WFS1, LOXL1, MMP19, NR2F1 and PMPCA. No pathogenic mitochondrial DNA variants were found in this group. CONCLUSIONS OCT can detect presence of asymptomatic optic neuropathy in patients with chronic alcohol use disorder. Furthermore, genetic susceptibility to optic neuropathy in this setting is found in almost a quarter of affected patients. Further studies may clarify the role of preventative measures in patients who might be predisposed to avoidable visual loss and blindness.
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Affiliation(s)
- Camille Delibes
- Département d'Ophtalmologie, Centre Hospitalier Universitaire (CHU), 49000, Angers, France
| | - Marc Ferré
- Université d'Angers, Unité Mixte de Recherche (UMR) MITOVASC, Institut National de la Santé et de la Recherche Médicale (INSERM U-1083), Centre National de la Recherche Scientifique (CNRS 6015), 49000, Angers, France
- Département de Biochimie et Biologie Moléculaire, Centre Hospitalier Universitaire, 49000, Angers, France
| | - Marine Rozet
- Département de Psychiatrie et d'Addictologie, Centre Hospitalier Universitaire, 49000, Angers, France
| | - Valérie Desquiret-Dumas
- Université d'Angers, Unité Mixte de Recherche (UMR) MITOVASC, Institut National de la Santé et de la Recherche Médicale (INSERM U-1083), Centre National de la Recherche Scientifique (CNRS 6015), 49000, Angers, France
- Département de Biochimie et Biologie Moléculaire, Centre Hospitalier Universitaire, 49000, Angers, France
| | - Alexis Descatha
- Univ. Angers (University of Angers), CHU Angers, Univ. Rennes, Inserm, EHESP, IRSET (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, IRSET-ESTER, SFR ICAT, CAPTV CDC, 49000, Angers, France
- Department of Occupational Medicine, Epidemiology and Prevention, Donald and Barbara Zucker School of Medicine, Hosftra University Northwell Health, New York, NY, 11021, USA
| | - Bénédicte Gohier
- Département de Psychiatrie et d'Addictologie, Centre Hospitalier Universitaire, 49000, Angers, France
- Univ Angers, Université de Nantes, LPPL, SFR CONFLUENCES, 49000, Angers, France
| | - Philippe Gohier
- Département d'Ophtalmologie, Centre Hospitalier Universitaire (CHU), 49000, Angers, France
| | - Patrizia Amati-Bonneau
- Université d'Angers, Unité Mixte de Recherche (UMR) MITOVASC, Institut National de la Santé et de la Recherche Médicale (INSERM U-1083), Centre National de la Recherche Scientifique (CNRS 6015), 49000, Angers, France
- Département de Biochimie et Biologie Moléculaire, Centre Hospitalier Universitaire, 49000, Angers, France
| | - Dan Milea
- Département d'Ophtalmologie, Centre Hospitalier Universitaire (CHU), 49000, Angers, France
- Singapore National Eye Centre, Singapore Eye Research Institute, Duke-NUS, Singapore, Singapore
- Rothschild Foundation Hospital, Paris, France
| | - Pascal Reynier
- Université d'Angers, Unité Mixte de Recherche (UMR) MITOVASC, Institut National de la Santé et de la Recherche Médicale (INSERM U-1083), Centre National de la Recherche Scientifique (CNRS 6015), 49000, Angers, France.
- Département de Biochimie et Biologie Moléculaire, Centre Hospitalier Universitaire, 49000, Angers, France.
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Lombardo M, Cusumano A, Mancino R, Aiello F, Sorge RP, Nucci C, Cesareo M. Short Wavelength Automated Perimetry, Standard Automated Perimetry, and Optical Coherence Tomography in Dominant Optic Atrophy. J Clin Med 2024; 13:1971. [PMID: 38610740 PMCID: PMC11012462 DOI: 10.3390/jcm13071971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Revised: 02/19/2024] [Accepted: 03/27/2024] [Indexed: 04/14/2024] Open
Abstract
Background: Blue-yellow axis dyschromatopsia is well-known in Autosomal Dominant Optic Atrophy (ADOA) patients, but there were no data on the correlation between retinal structure and short-wavelength automated perimetry (SWAP) values in this pathology. Methods: In this cross-sectional case-control study, we assessed the correlation between best corrected visual acuity (BCVA), standard automated perimetry (SAP), SWAP, and optical coherence tomography (OCT) parameters of 9 ADOA patients compared with healthy controls. Correlation analysis was performed between BCVA, mean deviation, pattern standard deviation (PSD), and fovea sensitivity (FS) values and the OCT thickness of each retinal layer and the peripapillary retinal nerve fiber layer (pRNFL). Results: The following significant and strong correlations were found: between BCVA and ganglion cell layer (GCL) and the global (G) pRNFL thicknesses; between SAP FS and GCL and the G-pRNFL thicknesses; between SWAP PSD and total retina, GCL, inner plexiform layer, inner nuclear layer, inner retinal layer and the temporal pRNFL thicknesses. We found a constant shorter duration of the SITA-SWAP compared with the SITA-STANDARD strategy. Conclusions: SWAP, SAP, and BCVA values provided relevant clinical information about retinal involvement in our ADOA patients. The perimetric functional parameters that seemed to correlate better with structure involvement were FS on SAP and PSD on SWAP.
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Affiliation(s)
- Marco Lombardo
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Andrea Cusumano
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Raffaele Mancino
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Francesco Aiello
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Roberto Pietro Sorge
- Laboratory of Biometry, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Carlo Nucci
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Massimo Cesareo
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
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Battista M, Coutinho CP, Berni A, Borrelli E, Galzignato A, Lari G, Checchin L, Pizza IC, Brotto L, Nucci P, Bandello F, Cascavilla ML, Barboni P. Sectorial Ganglion Cell Complex Thickness as Biomarker of Vision Outcome in Patients With Dominant Optic Atrophy. Invest Ophthalmol Vis Sci 2024; 65:24. [PMID: 38193759 PMCID: PMC10784844 DOI: 10.1167/iovs.65.1.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 12/04/2023] [Indexed: 01/10/2024] Open
Abstract
Purpose Dominant optic atrophy (DOA) is an inherited condition caused by autosomal dominant mutations involving the OPA-1 gene. The aim of this study was to assess the relationship between macular ganglion cell and inner plexiform layer (GC-IPL) thickness obtained from structural optical coherence tomography (OCT) and visual outcomes in DOA patients. Methods The study recruited 33 patients with confirmed OPA-1 heterozygous mutation and DOA. OCT scans were conducted to measure the GC-IPL thickness. The average and sectorial Early Treatment Diabetic Retinopathy Study (ETDRS) charts (six-sector macular analysis to enhance the topographical analysis) centered on the fovea were considered. Several regression analyses were carried out to investigate the associations between OCT metrics and final best-corrected visual acuity (BCVA) as the dependent variable. Results The mean BCVA was 0.43 ± 0.37 logMAR, and the average macular GC-IPL thickness was 43.65 ± 12.56 µm. All of the GC-IPL sectors were significantly reduced and correlated with BCVA. The univariate linear regression and the multivariate stepwise regression modeling showed that the strongest association with final BCVA was observed with the internal superior GC-IPL thickness. Dividing patients based on BCVA, we found a specific pattern. Specifically, in patients with BCVA ≤ 0.3 logMAR, the external superior and inferior sectors together with the internal superior were more significant; whereas, for BCVA > 0.3 logMAR, the external superior sector and internal superior sector were more significant. Conclusions The study identified OCT biomarkers associated with visual outcomes in DOA patients. Moreover, we assessed a specific OCT biomarker for DOA progression, ranging from patients in the early stages of disease with more preserved GC-IPL sectorial thickness to advanced stages with severe thinning.
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Affiliation(s)
- Marco Battista
- Department of Ophthalmology, University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy
| | | | - Alessandro Berni
- Department of Ophthalmology, University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Enrico Borrelli
- Department of Ophthalmology, University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy
| | | | - Giorgio Lari
- Department of Ophthalmology, University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Lisa Checchin
- Department of Ophthalmology, University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Irene C. Pizza
- Department of Ophthalmology, University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Luigi Brotto
- Department of Clinical Science and Community Health, University of Milan, Milan, Italy
| | - Paolo Nucci
- Department of Clinical Science and Community Health, University of Milan, Milan, Italy
| | - Francesco Bandello
- Department of Ophthalmology, University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Maria Lucia Cascavilla
- Department of Ophthalmology, University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Piero Barboni
- Department of Ophthalmology, University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy
- Studio Oculistico d'Azeglio, Bologna, Italy
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Sen S, Mandal S, Banerjee M, Gk R, Saxena A, Aalok SP, Saxena R. Ethambutol-induced optic neuropathy: Functional and structural changes in the retina and optic nerve. Semin Ophthalmol 2022; 37:730-739. [PMID: 35699333 DOI: 10.1080/08820538.2022.2085517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUD Ethambutol hydrochloride (EMB) is used in the treatment of tuberculosis and is used as first line modality in combination with other medications. Ethambutol optic neuropathy (EON) is a rare but well-recognised adverse ocular event in patients who receive ethambutol for the treatment of mycobacterial infections and may be potentially devastating with reversible to irreversible changes in visual acuity. KEY FINDINGS Optical coherence tomography has been used to evaluate the thickness of retinal nerve fibre and ganglion cell layers to look for degenerative changes and early markers. Electrophysiological tests like multifocal electroretinogram, visual evoked potentials and visual fields have been used to understand the functional changes associated with established EON and also whether these can be used to detect subclinical EON and correlate them with the structural changes. In this review, we have summarised evidence published till December 2021 related to evaluation of structural and functional changes in the retina and optic nerve in eyes with EON.
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Affiliation(s)
- Sagnik Sen
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Sohini Mandal
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Mousumi Banerjee
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Ranjitha Gk
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | | | | | - Rohit Saxena
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
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Zehden JA, Raviskanthan S, Mortensen PW, Ferré M, Reynier P, Milea D, Lee AG. Dominant Optic Atrophy: How to Determine the Pathogenicity of Novel Variants? J Neuroophthalmol 2022; 42:149-153. [PMID: 34629404 DOI: 10.1097/wno.0000000000001352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Jason A Zehden
- Baylor College of Medicine (JZ), Houston, Texas, US; Department of Ophthalmology (SR, PWM, AGL), Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas; MITOVASC Institute (MF, PR, DM), CNRS 6015, INSERM U1083, University of Angers, France ; Singapore National Eye Center (DM), Singapore, Singapore ; Singapore Eye Research Institute (DM), Singapore, Singapore ; Duke-NUS Medical School (DM), Singapore, Singapore ; Copenhagen University Hospital Denmark (DM), Copenhagen, Denmark; Departments of Ophthalmology (AGL), Neurology, and Neurosurgery, Weill Cornell Medicine, New York, New York; Department of Ophthalmology (AGL), University of Texas Medical Branch, Galveston, Texas; University of Texas MD Anderson Cancer Center (AGL), Houston, Texas; Texas A and M College of Medicine (AGL), Bryan, Texas; and Department of Ophthalmology (AGL), The University of Iowa Hospitals and Clinics, Iowa City, Iowa
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7
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Huna-Baron R, Yahalom G, Anikster Y, Ben Zeev B, Hoffmann C, Hassin-Baer S. Neuro-Ophthalmic Phenotype of OPA3. J Neuroophthalmol 2022; 42:e147-e152. [PMID: 33870938 DOI: 10.1097/wno.0000000000001249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Type III 3-methylglutaconic aciduria (OPA 3) is a neuro-ophthalmologic syndrome consisting of early-onset bilateral optic atrophy. Since Costeff described the phenotype of 19 patients in 1989, several reports described approximately 50 patients, but most of them lack details about neuro-ophthalmic phenotype. Our aim was to characterize the clinical neuro-ophthalmic phenotype of this syndrome. METHODS Nine patients underwent meticulous visual function history and medical documents' review. Results of best-corrected visual acuity (VA), color vision, visual field (VF), ocular motility, pupillary reaction, slit-lamp, and dilated fundus examinations were recorded. Optical coherence tomography (OCT) was performed whenever possible. RESULTS The average VA was 1.4 ± 0.8 logarithm of the minimum angle of resolution. Poor vision was the presenting symptom in 5 patients. Six patients had decreased VA and variable degrees of optic atrophy. Humphrey VF testing of 7 patients revealed generalized depression in 5 and a cecocentral defect in 2. All patients demonstrated dysmetric saccades. Four patients had strabismus, 3 with exotropia, and one with esotropia. Seven patients had nystagmus. Ocular motility abnormality is possibly the result of cerebellar atrophy that was found in MRI studies of our patients. OCT of the retina was possible in 6 patients and revealed retinal nerve fiber layer (RNFL) thinning as well as average retinal thinning. Three patients, in whom ganglion cell layer-inner plexiform layer (IPL) measurement was possible, also showed diffused thinning. CONCLUSIONS This study compiled data regarding neuro-ophthalmic manifestation of OPA 3 Type III patients. Contrary to established literature, poor vision was the presenting symptom in only 50% of our patients. This is the first report of OCT findings in 3MGA patients. The results demonstrated diffused thinning of the RNFL and ganglion cell complex-IPL with correlation to VA, which is in contrast to OPA1 patients in whom the most severe thinning is at the level of the papillomacular bundle. Average retinal thinning was identified at second and third decades of life, possibly resulting from early ganglion cell loss. These results may contribute to visual prognosis, and OCT may help monitor experimental therapies.
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Affiliation(s)
- Ruth Huna-Baron
- Neuro-Ophthalmology Unit (RH-B), Goldschleger Eye Institute Chaim Sheba Medical Center, Tel-Hashomer, Israel ; Department of Neurology (GY, SH-B), Sagol Neuroscience Center, Chaim Sheba Medical Center, Tel-Hashomer, Israel; Movement Disorders Clinic and Department of Neurology (GY), Shaare Zedek Medical Center, Jerusalem, Israel ; Metabolic Disease Unit Edmond and Lily Safra Children's Hospital (YA), Chaim Sheba Medical Center, Tel-Hashomer, Israel ; Pediatric Neurology Unit (BBZ), Edmond and Lily Safra Children's Hospital, Chaim Sheba Medical Center, Tel-Hashomer, Israel; Radiology Department (CH), Chaim Sheba Medical Center, Tel-Hashomer, Israel ; and Sackler Faculty of Medicine (RH-B, YA, BBZ, CH, SH-B), Tel-Aviv University, Tel-Aviv, Israel
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Raviskanthan S, Ahuja P, Mortensen PW, Milea D, Lee AG. Delayed diagnosis of autosomal dominant optic atrophy until seventh decade of life. Can J Ophthalmol 2021; 57:e96-e100. [PMID: 34534508 DOI: 10.1016/j.jcjo.2021.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/05/2021] [Accepted: 08/17/2021] [Indexed: 11/16/2022]
Affiliation(s)
| | - Pranati Ahuja
- School of Medicine, University of Texas Medical Branch, Galveston, Tex
| | | | - Dan Milea
- Singapore National Eye Center, Singapore;; Singapore Eye Research Institute, Singapore;; Duke-NUS Medical School, Singapore;; Copenhagen University Hospital, Copenhagen, Denmark
| | - Andrew G Lee
- Blanton Eye Institute, Houston Methodist Hospital, Houston, Tex.;; Weill Cornell Medicine, New York, NY;; University of Texas Medical Branch, Galveston, Tex.;; University of Texas MD Anderson Cancer Center, Houston, Tex.;; Texas A&M College of Medicine, Bryan, Tex.;; University of Iowa Hospitals and Clinics, Iowa City, Iowa;.
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9
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Leahy KE, Wright T, Grudzinska Pechhacker MK, Audo I, Tumber A, Tavares E, MacDonald H, Locke J, VandenHoven C, Zeitz C, Heon E, Buncic JR, Vincent A. Optic Atrophy and Inner Retinal Thinning in CACNA1F-related Congenital Stationary Night Blindness. Genes (Basel) 2021; 12:genes12030330. [PMID: 33668843 PMCID: PMC7996180 DOI: 10.3390/genes12030330] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 02/06/2021] [Accepted: 02/20/2021] [Indexed: 12/25/2022] Open
Abstract
Hemizygous pathogenic variants in CACNA1F lead to defective signal transmission from retinal photoreceptors to bipolar cells and cause incomplete congenital stationary night blindness in humans. Although the primary defect is at the terminal end of first-order neurons (photoreceptors), there is limited knowledge of higher-order neuronal changes (inner retinal) in this disorder. This study aimed to investigate inner retinal changes in CACNA1F-retinopathy by analyzing macular ganglion cell layer-inner plexiform layer (GCL-IPL) thickness and optic disc pallor in 22 subjects with molecularly confirmed CACNA1F-retinopathy. Detailed ocular phenotypic data including distance and color vision, refraction and electroretinogram (ERG) were collected. Distance vision was universally reduced (mean: 0.42 LogMAR), six had abnormal color vision and myopia was common (n = 15; mean: −6.32 diopters). Mean GCL-IPL thickness was significantly lower in patients (55.00 µm) compared to age-matched controls (n = 87; 84.57 µm; p << 0.001). The GCL-IPL thickness correlated with scotopic standard (p = 0.04) and bright-flash (p = 0.014) ERG b/a ratios and photopic b-wave amplitudes (p = 0.05). Twenty-one patients had some degree of disc pallor (bilateral in 19). Fifteen putative disease-causing, including five novel variants were identified. This study establishes macular inner retinal thinning and optic atrophy as characteristic features of CACNA1F-retinopathy, which are independent of myopia and could impact potential future treatment strategies.
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Affiliation(s)
- Kate E Leahy
- Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; (K.E.L.); (M.K.G.P.); (A.T.); (H.M.); (J.L.); (C.V.); (E.H.); (J.R.B.)
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON M5T 3A9, Canada;
| | - Tom Wright
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON M5T 3A9, Canada;
- Kensington Eye Institute, Toronto, ON M5T 3A9, Canada
| | - Monika K Grudzinska Pechhacker
- Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; (K.E.L.); (M.K.G.P.); (A.T.); (H.M.); (J.L.); (C.V.); (E.H.); (J.R.B.)
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON M5T 3A9, Canada;
| | - Isabelle Audo
- INSERM, CNRS, Institut de la Vision, Sorbonne Université, 75012 Paris, France; (I.A.); (C.Z.)
- CHNO des Quinze-Vingts, DHU Sight Restore, INSERM-DGOS CIC 1423, 75012 Paris, France
- Institute of Ophthalmology, University College of London, London EC1V 9EL, UK
| | - Anupreet Tumber
- Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; (K.E.L.); (M.K.G.P.); (A.T.); (H.M.); (J.L.); (C.V.); (E.H.); (J.R.B.)
| | - Erika Tavares
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada;
| | - Heather MacDonald
- Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; (K.E.L.); (M.K.G.P.); (A.T.); (H.M.); (J.L.); (C.V.); (E.H.); (J.R.B.)
- Department of Molecular Genetics, University of Toronto, Toronto, ON M5S 1A8, Canada
- Department of Genetic Counselling, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
| | - Jeff Locke
- Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; (K.E.L.); (M.K.G.P.); (A.T.); (H.M.); (J.L.); (C.V.); (E.H.); (J.R.B.)
| | - Cynthia VandenHoven
- Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; (K.E.L.); (M.K.G.P.); (A.T.); (H.M.); (J.L.); (C.V.); (E.H.); (J.R.B.)
| | - Christina Zeitz
- INSERM, CNRS, Institut de la Vision, Sorbonne Université, 75012 Paris, France; (I.A.); (C.Z.)
| | - Elise Heon
- Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; (K.E.L.); (M.K.G.P.); (A.T.); (H.M.); (J.L.); (C.V.); (E.H.); (J.R.B.)
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON M5T 3A9, Canada;
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada;
| | - J Raymond Buncic
- Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; (K.E.L.); (M.K.G.P.); (A.T.); (H.M.); (J.L.); (C.V.); (E.H.); (J.R.B.)
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON M5T 3A9, Canada;
| | - Ajoy Vincent
- Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; (K.E.L.); (M.K.G.P.); (A.T.); (H.M.); (J.L.); (C.V.); (E.H.); (J.R.B.)
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON M5T 3A9, Canada;
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada;
- Correspondence: ; Tel.: +1-416-813-1500
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Stockman A, Henning GB, Rider AT. Clinical vision and molecular loss: Integrating visual psychophysics with molecular genetics reveals key details of normal and abnormal visual processing. Prog Retin Eye Res 2020; 83:100937. [PMID: 33388434 DOI: 10.1016/j.preteyeres.2020.100937] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 12/11/2020] [Accepted: 12/17/2020] [Indexed: 01/08/2023]
Abstract
Over the past two decades we have developed techniques and models to investigate the ways in which known molecular defects affect visual performance. Because molecular defects in retinal signalling invariably alter the speed of visual processing, our strategy has been to measure the resulting changes in flicker sensitivity. Flicker measurements provide not only straightforward clinical assessments of visual performance but also reveal fundamental details about the functioning of both abnormal and normal visual systems. Here, we bring together our past measurements of patients with pathogenic variants in the GNAT2, RGS9, GUCA1A, RPE65, OPA1, KCNV2 and NR2E3 genes and analyse the results using a standard model of visual processing. The model treats flicker sensitivity as the result of the actions of a sequence of simple processing steps, one or more of which is altered by the genetic defect. Our analyses show that most defects slow down the visual response directly, but some speed it up. Crucially, however, other steps in the processing sequence can make compensatory adjustments to offset the abnormality. For example, if the abnormal step slows down the visual response, another step is likely to speed up or attenuate the response to rebalance system performance. Such compensatory adjustments are probably made by steps in the sequence that usually adapt to changing light levels. Our techniques and modelling also allow us to tease apart stationary and progressive effects, and the localised molecular losses help us to unravel and characterise individual steps in the normal and abnormal processing sequences.
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Affiliation(s)
- Andrew Stockman
- UCL Institute of Ophthalmology, 11-43 Bath Street, London, EC1V 9EL, England, UK.
| | - G Bruce Henning
- UCL Institute of Ophthalmology, 11-43 Bath Street, London, EC1V 9EL, England, UK
| | - Andrew T Rider
- UCL Institute of Ophthalmology, 11-43 Bath Street, London, EC1V 9EL, England, UK
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Hanai K, Hashimoto M, Ishikawa F, Nakamura H. Congenital geniculate quadruple sectoranopia with occipital heterotopia. Am J Ophthalmol Case Rep 2020; 20:100929. [PMID: 33005817 PMCID: PMC7509790 DOI: 10.1016/j.ajoc.2020.100929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 09/13/2020] [Indexed: 11/29/2022] Open
Abstract
Purpose To report a case of congenital geniculate quadruple sectoranopia associated with occipital heterotopia. Observations A 51-year-old healthy woman was incidentally found to have a left incongruous quadruple sectoranopia. Analysis of the macular ganglion cell complex (GCC) revealed homonymous hemianopic thinning of the inner layer of the retina. Brain magnetic resonance imaging (MRI) showed congenital occipital heterotopia, characterized by hypertrophy of the right parahippocampal gyrus, lingual gyrus, and isthmus of the cingulate gyrus, with shrinkage of the white matter. In addition, serial coronal images on a short tau inversion recovery (STIR) sequence demonstrated an atrophic right optic tract. Conclusion and importance Congenital geniculate quadruple sectoranopia is extremely rare and may be caused by congenital occipital heterotopia.
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Affiliation(s)
- Kaori Hanai
- Department of Ophthalmology, Nakamura Memorial Hospital, S-1, W-14, Chuo-ku, Sapporo, Japan
- Corresponding author.
| | - Masato Hashimoto
- Department of Ophthalmology, Nakamura Memorial Hospital, S-1, W-14, Chuo-ku, Sapporo, Japan
| | - Futoshi Ishikawa
- Fushiminishisen Ishikawa Eye Clinic, S-20, W-14, Chuo-ku, Sapporo, Japan
| | - Hirohiko Nakamura
- Department of Neurosurgery, Nakamura Memorial Hospital, S-1, W-14, Chuo-ku, Sapporo, Japan
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Corajevic N, Larsen M, Rönnbäck C. Thickness mapping of individual retinal layers and sectors by Spectralis SD-OCT in Autosomal Dominant Optic Atrophy. Acta Ophthalmol 2018; 96:251-256. [PMID: 29091347 DOI: 10.1111/aos.13588] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2017] [Accepted: 08/11/2017] [Indexed: 01/06/2023]
Abstract
PURPOSE To assess layer- and location-specific retinal thickness deficits in autosomal dominant optic atrophy (ADOA) using Spectralis SD-OCT. METHODS This cross-sectional study included 41 ADOA patients with OPA1 exon 28 (2826delT) mutation [age, 8.6-83.5 years; best-corrected visual acuity (BCVA), 8-89 Early Treatment Diabetic Retinopathy Study (ETDRS) letters] and 55 mutation-free first-degree relatives as healthy controls (age, 8.9-68.7; BCVA, 80-99). Participants underwent routine examination and optical coherence tomography (OCT) with segmentation of the whole retina, inner retinal layers (IRL) and outer retinal layers (ORL). Individual segmentation was performed of the perifoveal retinal nerve fibre layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer (INL), outer plexiform layer (OPL), outer nuclear layer (ONL), retinal pigment epithelium (RPE) and the peripapillary RNFL. Combinations of layers and sectors were tested for their diagnostic significance. Only right eye data are presented. Statistical analysis was adjusted for age, gender, spherical equivalent, axial length and family clustering in a mixed model analysis. RESULTS The perifoveal RNFL, GCL, IPL and the peripapillary RNFL were all significantly thinner in ADOA patients than in healthy controls (p < 0.0001). No statistical difference was found for other layers. The most prominent and diagnostically most valuable deficit was found in the GCL (-49.9%) in the 'nasal inner macula' (NIM) sector (-63%). Attenuation of the peripapillary RNFL was most significant in the temporal sector (-58.4%). CONCLUSION In ADOA, retinal ganglion cells are most prominently reduced in the nasal perifoveal area of the GCL, which together with the temporal peripapillary RNFL area serves as the strongest diagnostic OCT marker.
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Affiliation(s)
- Nihada Corajevic
- Department of Ophthalmology; Glostrup Hospital; Copenhagen Denmark
| | - Michael Larsen
- Department of Ophthalmology; Glostrup Hospital; Copenhagen Denmark
| | - Cecilia Rönnbäck
- Department of Ophthalmology; Glostrup Hospital; Copenhagen Denmark
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Lee JY, Han J, Seo JG, Park KA, Oh SY. Diagnostic value of ganglion cell-inner plexiform layer for early detection of ethambutol-induced optic neuropathy. Br J Ophthalmol 2018; 103:379-384. [PMID: 29699978 DOI: 10.1136/bjophthalmol-2018-312063] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 04/12/2018] [Indexed: 01/18/2023]
Abstract
AIM To evaluate the diagnostic value of macular ganglion cell-inner plexiform layer (mGCIPL) thickness versus peripapillary retinal nerve fibre layer (pRNFL) thickness for the early detection of ethambutol-induced optic neuropathy (EON). METHODS Twenty-eight eyes of 15 patients in the EON group and 100 eyes of 53 healthy subjects in the control group were included. All patients with EON demonstrated the onset of visual symptoms within 3 weeks. Diagnostic power for pRNFL and mGCIPL thicknesses measured by Cirrus spectral-domain optical coherence tomography was assessed by area under the receiver operating characteristic (AUROC) curves and sensitivity. RESULTS All of the mGCIPL thickness measurements were thinner in the EON group than in the control group in early EON (p<0.001). All of pRNFL thicknesses except inferior RNFL showed AUROC curves above 0.5, and all of the mGCIPL thicknesses showed AUROC curves above 0.5. The AUROC of the average mGCIPL (0.812) thickness was significantly greater than that of the average pRNFL (0.507) thickness (p<0.001). Of all the mGCIPL-related parameters considered, the minimum thickness showed the greatest AUROC value (0.863). The average mGCIPL thickness showed a weak correlation with visual field pattern standard deviations (r2=0.158, p<0.001). CONCLUSIONS In challenging cases of EON, the mGCIPL thickness has better diagnostic performance in detecting early-onset EON as compared with using pRNFL thickness. Among the early detection ability of mGCIPL thickness, minimum GCIPL thickness has high diagnostic ability.
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Affiliation(s)
- Ju-Yeun Lee
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jinu Han
- Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, South Korea
| | - Jeong Gi Seo
- Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, South Korea
| | - Kyung-Ah Park
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Sei Yeul Oh
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
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Pretegiani E, Rosini F, Rufa A, Gallus G, Cardaioli E, Da Pozzo P, Bianchi S, Serchi V, Collura M, Franceschini R, Bianchi Marzoli S, Dotti M, Federico A. Genotype-phenotype and OCT correlations in Autosomal Dominant Optic Atrophy related to OPA1 gene mutations: Report of 13 Italian families. J Neurol Sci 2017; 382:29-35. [DOI: 10.1016/j.jns.2017.09.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 09/09/2017] [Accepted: 09/12/2017] [Indexed: 10/18/2022]
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Avoiding Clinical Misinterpretation and Artifacts of Optical Coherence Tomography Analysis of the Optic Nerve, Retinal Nerve Fiber Layer, and Ganglion Cell Layer. J Neuroophthalmol 2017; 36:417-438. [PMID: 27636747 PMCID: PMC5113253 DOI: 10.1097/wno.0000000000000422] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Background: Optical coherence tomography (OCT) has become an important tool for diagnosing optic nerve disease. The structural details and reproducibility of OCT continues to improve with further advances in technology. However, artifacts and misinterpretation of OCT can lead to clinical misdiagnosis of diseases if they go unrecognized. Evidence Acquisition: A literature review using PubMed combined with clinical and research experience. Results: We describe the most common artifacts and errors in interpretation seen on OCT in both optic nerve and ganglion cell analyses. We provide examples of the artifacts, discuss the causes, and provide methods of detecting them. In addition, we discuss a systematic approach to OCT analysis to facilitate the recognition of artifacts and to avoid clinical misinterpretation. Conclusions: While OCT is invaluable in diagnosing optic nerve disease, we need to be cognizant of the artifacts that can occur with OCT. Failure to recognize some of these artifacts can lead to misdiagnoses and inappropriate investigations.
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Ba-Ali S, Lund-Andersen H. Pupillometric evaluation of the melanopsin containing retinal ganglion cells in mitochondrial and non-mitochondrial optic neuropathies. Mitochondrion 2017; 36:124-129. [PMID: 28716667 DOI: 10.1016/j.mito.2017.07.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 05/29/2017] [Accepted: 07/13/2017] [Indexed: 01/08/2023]
Abstract
In recent years, chromatic pupillometry is used in humans to evaluate the activity of melanopsin expressing intrinsic photosensitive retinal ganglion cells (ipRGCs). Blue light is used to stimulate the ipRGCs and red light activates the rod/cone photoreceptors. The late re-dilation phase of pupillary light reflex is primarily driven by the ipRGCs. Optic neuropathies i.e. Leber hereditary optic neuropathy (LHON), autosomal dominant optic atrophy (ADOA), nonarteritic anterior ischemic optic neuropathy (NAION), glaucoma, optic neuritis and idiopathic intracranial hypertension (IIH) are among the diseases, which have been subject to pupillometric studies. The ipRGCs are differentially affected in these various optic neuropathies. In mitochondrial optic neuropathies, the ipRGCs are protected against degeneration, whereas in glaucoma, NAION, optic neuritis and IIH the ipRGCs are damaged. Here, we will review the results of pupillometric, histopathological and animal studies evaluating the ipRGCs in mitochondrial and non-mitochondrial optic neuropathies.
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Affiliation(s)
- Shakoor Ba-Ali
- Department of Ophthalmology, Rigshospitalet, Glostrup, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| | - Henrik Lund-Andersen
- Department of Ophthalmology, Rigshospitalet, Glostrup, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Majander A, João C, Rider AT, Henning GB, Votruba M, Moore AT, Yu-Wai-Man P, Stockman A. The Pattern of Retinal Ganglion Cell Loss in OPA1-Related Autosomal Dominant Optic Atrophy Inferred From Temporal, Spatial, and Chromatic Sensitivity Losses. Invest Ophthalmol Vis Sci 2017; 58:502-516. [PMID: 28125838 PMCID: PMC5283089 DOI: 10.1167/iovs.16-20309] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose Progressive retinal ganglion cell (RGC) loss is the pathological hallmark of autosomal dominant optic atrophy (DOA) caused by pathogenic OPA1 mutations. The aim of this study was to conduct an in-depth psychophysical study of the visual losses in DOA and to infer any selective vulnerability of visual pathways subserved by different RGC subtypes. Methods We recruited 25 patients carrying pathogenic OPA1 mutations and age-matched healthy individuals. Spatial contrast sensitivity functions (SCSFs) and chromatic contrast sensitivity were quantified, the latter using the Cambridge Colour Test. In 11 patients, long (L) and short (S) wavelength-sensitive cone temporal acuities were measured as a function of target illuminance, and L-cone temporal contrast sensitivity (TCSF) as a function of temporal frequency. Results Spatial contrast sensitivity functions were abnormal, with the loss of sensitivity increasing with spatial frequency. Further, the highest L-cone temporal acuity fell on average by 10 Hz and the TCSFs by 0.66 log10 unit. Chromatic thresholds along the protan, deutan, and tritan axes were 8, 9, and 14 times higher than normal, respectively, with losses increasing with age and S-cone temporal acuity showing the most significant age-related decline. Conclusions Losses of midget parvocellular, parasol magnocellular, and bistratified koniocellular RGCs could account for the losses of high spatial frequency sensitivity and protan and deutan sensitivities, high temporal frequency sensitivity, and S-cone temporal and tritan sensitivities, respectively. The S-cone-related losses showed a significant deterioration with increasing patient age and could therefore prove useful biomarkers of disease progression in DOA.
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Affiliation(s)
- Anna Majander
- University College London, Institute of Ophthalmology, London, United Kingdom 2Moorfields Eye Hospital, London, United Kingdom 3Department of Ophthalmology, University of Helsinki, and Helsinki University Hospital, Helsinki, Finland
| | - Catarina João
- University College London, Institute of Ophthalmology, London, United Kingdom
| | - Andrew T Rider
- University College London, Institute of Ophthalmology, London, United Kingdom
| | - G Bruce Henning
- University College London, Institute of Ophthalmology, London, United Kingdom
| | - Marcela Votruba
- School of Optometry and Vision Sciences, Cardiff University Cardiff, and Cardiff Eye Unit, University Hospital Wales, Cardiff, United Kingdom
| | - Anthony T Moore
- University College London, Institute of Ophthalmology, London, United Kingdom 2Moorfields Eye Hospital, London, United Kingdom 5Ophthalmology Department, University of California-San Francisco School of Medicine, San Francisco, California, United States
| | - Patrick Yu-Wai-Man
- University College London, Institute of Ophthalmology, London, United Kingdom 2Moorfields Eye Hospital, London, United Kingdom 6Wellcome Trust Centre for Mitochondrial Research, Institute of Genetic Medicine, Newcastle University and Newcastle Eye Centre, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom
| | - Andrew Stockman
- University College London, Institute of Ophthalmology, London, United Kingdom
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Assessment of the retinal posterior pole in dominant optic atrophy by spectral-domain optical coherence tomography and microperimetry. PLoS One 2017; 12:e0174560. [PMID: 28358911 PMCID: PMC5373574 DOI: 10.1371/journal.pone.0174560] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 03/11/2017] [Indexed: 11/24/2022] Open
Abstract
Background To assess posterior pole (PP) retinal structure in patients with genetically confirmed autosomal dominant optic atrophy (ADOA) using new spectral domain optical coherence tomography (SD-OCT) segmentation technology. To analyze retinal PP thickness in relation to retinal sensitivity data from microperimetry (MP) in ADOA patients. Methods and findings This prospective cross-sectional study included 11 patients with ADOA and 11 age-matched healthy subjects. All participants underwent both a “Posterior Pole” and “peripapillary RNFL (pRNFL)” scanning protocol using SD-OCT. Functional mapping of the PP was also performed using MP. A customized program was implemented in order to achieve accurate superimposition of MP sensitivity map onto SD-OCT map. The thickness of the PP different retinal layers and pRNFL was obtained and measured for each eye. Mean retinal sensitivity values and fixation stability were obtained and compared between ADOA patients and healthy subjects. Correlation analysis was performed on a point-to-point basis to evaluate the association between mean thickness and retinal sensitivity of each retinal layer. Total retinal thickness (TRT), Retinal Nerve Fiber Layer (RNFL), Ganglion Cell Layer (GCL), Inner Plexiform Layer (IPL), Inner Nuclear Layer (INL) and Inner Retinal Layers (IRL) at the posterior pole as well as pRNFL were significantly thinner in ADOA patients (P < 0.0001). On the contrary, the Outer Plexiform Layer (OPL) and the Outer Nuclear Layer (ONL) were significantly thicker in the ADOA group (P < 0.001). No significant differences were found in Retinal Pigment Epithelium (RPE) and Outer Retinal Layers (ORL) thickness between ADOA and controls. The average PP retinal sensitivity was significantly reduced in ADOA patients compared with controls (P < 0.001), as measured by microperimeter Nidek MP-1 (MP1). Fixation stability was significantly worse in the ADOA group (P = 0.01). The most severe sensitivity defects in ADOA patients were found at the level of the papillo-macular bundle (PMB). Conclusions Inner retinal layers showed pathological changes in ADOA patients. In addition, the whole retinal PP (not only the PMB) was significantly altered in ADOA, both in terms of retinal thickness and sensitivity.
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Soldath P, Wegener M, Sander B, Rosenberg T, Duno M, Wibrand F, Vissing J. Leber hereditary optic neuropathy due to a new ND1 mutation. Ophthalmic Genet 2017; 38:480-485. [DOI: 10.1080/13816810.2016.1253108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Patrick Soldath
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Copenhagen Neuromuscular Center, Department of Neurology, Rigshospitalet, Copenhagen, Denmark
| | - Marianne Wegener
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Ophthalmology, Rigshospitalet, Copenhagen, Denmark
| | - Birgit Sander
- Department of Ophthalmology, Rigshospitalet, Copenhagen, Denmark
| | - Thomas Rosenberg
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Ophthalmology, Rigshospitalet, Copenhagen, Denmark
| | - Morten Duno
- Department of Clinical Genetics, Rigshospitalet, Copenhagen, Denmark
| | - Flemming Wibrand
- Department of Clinical Genetics, Rigshospitalet, Copenhagen, Denmark
| | - John Vissing
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Copenhagen Neuromuscular Center, Department of Neurology, Rigshospitalet, Copenhagen, Denmark
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20
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Dominant optic atrophy: updates on the pathophysiology and clinical manifestations of the optic atrophy 1 mutation. Curr Opin Ophthalmol 2016; 27:475-480. [PMID: 27585216 DOI: 10.1097/icu.0000000000000314] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
PURPOSE OF REVIEW Review recent advances in clinical and experimental studies of dominant optic atrophy (DOA) to better understand the complexities of pathophysiology caused by the optic atrophy 1 (OPA1) mutation. RECENT FINDINGS DOA is the most commonly diagnosed inherited optic atrophy, causing progressive bilateral visual loss that begins early in life. During the past 25 years, there has been substantial progress in the understanding of the clinical, genetic, and pathophysiological basis of this disease. The histopathological hallmark of DOA is the primary degeneration of retinal ganglion cells, preferentially in the papillomacular bundle, which results temporal optic disc pallor and cecocentral scotomata in patients with DOA. Loss of OPA1 protein function by OPA1 gene mutations causes mitochondrial dysfunction because of the loss of mitochondrial fusion, impaired mitochondrial oxidative phosphorylation, increases in reactive oxygen species, and altered calcium homeostasis. These factors lead to apoptosis of retinal ganglion cells by a haploinsufficiency mechanism. SUMMARY Improved understanding of the pathophysiology of DOA provides insights that can be used to develop therapeutic approaches to the DOA.
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Optical Coherence Tomography Should Be Used Routinely to Monitor Patients With Idiopathic Intracranial Hypertension. J Neuroophthalmol 2016; 36:453-459. [DOI: 10.1097/wno.0000000000000379] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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22
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Inoue M, Himori N, Kunikata H, Takeshita T, Aizawa N, Shiga Y, Omodaka K, Nishiguchi KM, Takahashi H, Nakazawa T. The reduction of temporal optic nerve head microcirculation in autosomal dominant optic atrophy. Acta Ophthalmol 2016; 94:e580-e585. [PMID: 26936288 DOI: 10.1111/aos.12999] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2015] [Accepted: 12/28/2015] [Indexed: 11/29/2022]
Abstract
PURPOSE To evaluate the optic nerve head (ONH) microcirculation in autosomal dominant optic atrophy (ADOA) patients. METHODS This study comprised 22 eyes of 12 ADOA patients, diagnosed according to clinical findings including family history and the presence of mutations in the OPA1 gene. Twenty-four normal eyes of 24 age-matched subjects, with either the right or left eye randomly selected for use, served as controls. Circumpapillary retinal nerve fibre layer thickness (cpRNFLT) and mean blur rate (MBR) in the ONH were determined with optical coherence tomography (OCT) and laser speckle flowgraphy (LSFG), respectively. For each ONH quadrant (superior, temporal, inferior and nasal), the MBR and cpRNFLT ratio was also calculated by dividing tissue MBR in that quadrant by tissue MBR in the entire ONH and by dividing cpRNFLT in that quadrant by cpRNFLT in the entire ONH respectively. RESULTS Mean blur rate (MBR) in all quadrants was significantly lower in the ADOA patients than in the controls (p < 0.001 in each). The MBR ratio was significantly lower in the ADOA patients only in the temporal quadrant (p < 0.001). Similarly, cpRNFLT was lower in the ADOA patients in all quadrants (p < 0.001 in each), and the cpRNFLT ratio was lower in the temporal quadrant (p < 0.001). CONCLUSION Reduced blood flow in the temporal optic disc in ADOA patients is associated with reduced temporal cpRNFLT, suggesting that both are caused by damage to the papillomacular bundle. The anatomical characteristics of the papillomacular bundle may make it especially susceptible to mitochondrial dysfunction-induced damage, which occurs in ADOA.
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Affiliation(s)
- Maki Inoue
- Department of Ophthalmology; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Noriko Himori
- Department of Ophthalmology; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Hiroshi Kunikata
- Department of Ophthalmology; Tohoku University Graduate School of Medicine; Sendai Japan
- Department of Retinal Disease Control; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Takayuki Takeshita
- Department of Ophthalmology; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Naoko Aizawa
- Department of Ophthalmology; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Yukihiro Shiga
- Department of Ophthalmology; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Kazuko Omodaka
- Department of Ophthalmology; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Koji M Nishiguchi
- Department of Advanced Ophthalmic Medicine; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Hidetoshi Takahashi
- Department of Ophthalmology; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Toru Nakazawa
- Department of Ophthalmology; Tohoku University Graduate School of Medicine; Sendai Japan
- Department of Retinal Disease Control; Tohoku University Graduate School of Medicine; Sendai Japan
- Department of Advanced Ophthalmic Medicine; Tohoku University Graduate School of Medicine; Sendai Japan
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Retinal Ganglion Cell Layer Analysis by Optical Coherence Tomography in Toxic and Nutritional Optic Neuropathy. J Neuroophthalmol 2016; 35:242-5. [PMID: 25724010 DOI: 10.1097/wno.0000000000000229] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To analyze the retinal ganglion cell layer (RGL) by optical coherence tomography (OCT) in toxic and nutritional optic neuropathy and to correlate its thickness and volume with functional damage. METHODS We conducted an observational cross-sectional study in healthy subjects and in patients with toxic optic neuropathy observed in the Neuro-Ophthalmology Department of Central Lisbon Hospital Center. Complete ophthalmologic examination, OCT (Heidelberg Spectralis), and automated static perimetry were performed. Thickness and macular volume of RGL layer and inner plexiform layer were measured after manual segmentation. RESULTS The study included 16 eyes of 12 healthy subjects and 16 eyes of 8 patients with toxic and nutritional optic neuropathy. Age and gender did not differ between the 2 groups. Ethambutol was the cause of toxic optic neuropathy in 4 patients and nutritional factors (tobacco-alcohol) in 4 patients. A statistically significant decrease in thickness and volume of RGL, in all quadrants at 2 and 3 mm, was detected in individuals with optic neuropathy compared with controls (P < 0.01). A positive correlation between RGL thickness and mean deviation (MD) and between RGL volume and MD was detected (P < 0.05). There was a negative correlation between MD and time of disease (r = 0.846 P = 0.001) and a positive correlation between MD and visual acuity in logMAR (r = 0.739 P = 0.006). A majority of the structural parameters also correlated negatively with time of disease (P < 0.05). CONCLUSIONS Decreased RGL thickness and volume detected in this study support a mechanism of RGL toxicity. RGL analysis may contribute to the diagnosis and management of toxic and nutritional optic neuropathies.
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Sarzi E, Seveno M, Angebault C, Milea D, Rönnbäck C, Quilès M, Adrian M, Grenier J, Caignard A, Lacroux A, Lavergne C, Reynier P, Larsen M, Hamel CP, Delettre C, Lenaers G, Müller A. Increased steroidogenesis promotes early-onset and severe vision loss in females with OPA1 dominant optic atrophy. Hum Mol Genet 2016; 25:2539-2551. [PMID: 27260406 DOI: 10.1093/hmg/ddw117] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 03/26/2016] [Accepted: 04/12/2016] [Indexed: 11/13/2022] Open
Abstract
OPA1 mutations are responsible for autosomal dominant optic atrophy (ADOA), a progressive blinding disease characterized by retinal ganglion cell (RGC) degeneration and large phenotypic variations, the underlying mechanisms of which are poorly understood. OPA1 encodes a mitochondrial protein with essential biological functions, its main roles residing in the control of mitochondrial membrane dynamics as a pro-fusion protein and prevention of apoptosis. Considering recent findings showing the importance of the mitochondrial fusion process and the involvement of OPA1 in controlling steroidogenesis, we tested the hypothesis of deregulated steroid production in retina due to a disease-causing OPA1 mutation and its contribution to the visual phenotypic variations. Using the mouse model carrying the human recurrent OPA1 mutation, we disclosed that Opa1 haploinsufficiency leads to very high circulating levels of steroid precursor pregnenolone in females, causing an early-onset vision loss, abolished by ovariectomy. In addition, steroid production in retina is also increased which, in conjunction with high circulating levels, impairs estrogen receptor expression and mitochondrial respiratory complex IV activity, promoting RGC apoptosis in females. We further demonstrate the involvement of Muller glial cells as increased pregnenolone production in female cells is noxious and compromises their role in supporting RGC survival. In parallel, we analyzed ophthalmological data of a multicentre OPA1 patient cohort and found that women undergo more severe visual loss at adolescence and greater progressive thinning of the retinal nerve fibres than males. Thus, we disclosed a gender-dependent effect on ADOA severity, involving for the first time steroids and Müller glial cells, responsible for RGC degeneration.
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Affiliation(s)
- Emmanuelle Sarzi
- INSERM U1051 - Institut des Neurosciences de Montpellier, Montpellier, France,
| | - Marie Seveno
- INSERM U1051 - Institut des Neurosciences de Montpellier, Montpellier, France
| | - Claire Angebault
- INSERM U1051 - Institut des Neurosciences de Montpellier, Montpellier, France
| | - Dan Milea
- Département de Biochimie et Génétique, UMR CNRS 6214-INSERM 1083, Centre Hospitalier Universitaire, Angers, France.,Singapore National Eye Centre, Singapore.,Singapore Eye Research Institute, Singapore.,Duke-NUS, Singapore
| | - Cecilia Rönnbäck
- Department of Ophthalmology, Glostrup Hospital, Glostrup, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Melanie Quilès
- INSERM U1051 - Institut des Neurosciences de Montpellier, Montpellier, France.,Université de Montpellier - Faculté de Pharmacie-Montpellier, France
| | - Mathias Adrian
- INSERM U1051 - Institut des Neurosciences de Montpellier, Montpellier, France
| | - Joanna Grenier
- INSERM U1051 - Institut des Neurosciences de Montpellier, Montpellier, France.,Centre de référence des affections sensorielles d'origine génétique, Hôpital Gui de Chauliac, Montpellier, France
| | - Angélique Caignard
- Département de Biochimie et Génétique, UMR CNRS 6214-INSERM 1083, Centre Hospitalier Universitaire, Angers, France
| | - Annie Lacroux
- INSERM U1051 - Institut des Neurosciences de Montpellier, Montpellier, France.,Centre de référence des affections sensorielles d'origine génétique, Hôpital Gui de Chauliac, Montpellier, France
| | - Christian Lavergne
- Institut Montpelliérain Alexander Grothendieck. Université Montpellier 3, France and
| | - Pascal Reynier
- Département de Biochimie et Génétique, UMR CNRS 6214-INSERM 1083, Centre Hospitalier Universitaire, Angers, France
| | - Michael Larsen
- Department of Ophthalmology, Glostrup Hospital, Glostrup, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Christian P Hamel
- INSERM U1051 - Institut des Neurosciences de Montpellier, Montpellier, France.,Centre de référence des affections sensorielles d'origine génétique, Hôpital Gui de Chauliac, Montpellier, France
| | - Cécile Delettre
- INSERM U1051 - Institut des Neurosciences de Montpellier, Montpellier, France,
| | - Guy Lenaers
- INSERM U1051 - Institut des Neurosciences de Montpellier, Montpellier, France.,PREMMI, UMR CNRS 6214-INSERM 1083, Université d'Angers, France
| | - Agnès Müller
- INSERM U1051 - Institut des Neurosciences de Montpellier, Montpellier, France.,Université de Montpellier - Faculté de Pharmacie-Montpellier, France
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OPA1-related disorders: Diversity of clinical expression, modes of inheritance and pathophysiology. Neurobiol Dis 2016; 90:20-6. [DOI: 10.1016/j.nbd.2015.08.015] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 08/14/2015] [Accepted: 08/17/2015] [Indexed: 01/13/2023] Open
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Rönnbäck C, Nissen C, Almind GJ, Grønskov K, Milea D, Larsen M. Genotype-phenotype heterogeneity of ganglion cell and inner plexiform layer deficit in autosomal-dominant optic atrophy. Acta Ophthalmol 2015; 93:762-6. [PMID: 26385429 DOI: 10.1111/aos.12835] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 07/22/2015] [Indexed: 12/01/2022]
Abstract
PURPOSE To describe the thickness of the combined ganglion cell and inner plexiform layers (GC-IPL) and the peripapillary retinal nerve fibre layer (RNFL) in patients with OPA1 c.983A>G or c.2708_2711delTTAG autosomal-dominant optic atrophy (ADOA). METHODS The study included 20 individuals with c.983A>G and nine individuals with c.2708_2711delTTAG. Data for comparison were drawn from 49, previously published, individuals with OPA1 c.2826_2836delinsGGATGCTCCA and 51 individuals with no OPA1 mutation. Subjects underwent refraction, best-corrected visual acuity assessment, axial length measurement and high-definition optical coherence tomography. RESULTS There was overlap in GC-IPL thickness in subjects younger than 20-30 years between the two new groups of ADOA patients and controls. Numerical decreases in GC-IPL thickness with age did not reach statistical significance in individuals with c.983A>G (p = 0.18) or in healthy controls (p = 0.22), but it did in individuals with c.2708_2711delTTAG (p = 0.02). Visual acuity decreased with decreasing GC-IPL thickness (p = 0.0006 in c.983A>G and p = 0.0084 in c.2708_2711delTTAG). Unlike c.2826_2836delinsGGATGCTCCA, individuals with c.983A>G or c.2708_2711delTTAG did not show a pattern of maximum GC-IPL deficit inferonasal of the fovea. CONCLUSION Genotype-phenotype heterogeneity in OPA1 ADOA is evident when inner retinal atrophy is examined as a function of age. Thus, a pronounced decline with age in GC-IPL thickness is observed in c.2708_2711delTTAG ADOA, an intermediate decline with age is observed in c.983A>G ADOA, whereas little or no change with age is observed in c.2826_2836delinsGGATGCTCCA ADOA. This genotype-phenotype heterogeneity may explain why some patients have progressive visual loss while others have a relatively stable prognosis.
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Affiliation(s)
- Cecilia Rönnbäck
- Department of Ophthalmology; Glostrup Hospital; Glostrup Denmark
- Faculty of Health Sciences; University of Copenhagen; Copenhagen Denmark
| | - Claus Nissen
- Department of Ophthalmology; Glostrup Hospital; Glostrup Denmark
- Faculty of Health Sciences; University of Copenhagen; Copenhagen Denmark
| | - Gitte J. Almind
- Faculty of Health Sciences; University of Copenhagen; Copenhagen Denmark
- Kennedy Center; Clinical Genetic Clinic; Copenhagen Denmark
| | - Karen Grønskov
- Faculty of Health Sciences; University of Copenhagen; Copenhagen Denmark
- Kennedy Center; Clinical Genetic Clinic; Copenhagen Denmark
| | - Dan Milea
- Department of Ophthalmology; Glostrup Hospital; Glostrup Denmark
- Singapore Eye Research Institute; Singapore National Eye Centre and Duke-NUS; Singapore Singapore
| | - Michael Larsen
- Department of Ophthalmology; Glostrup Hospital; Glostrup Denmark
- Faculty of Health Sciences; University of Copenhagen; Copenhagen Denmark
- Kennedy Center; National Eye Clinic; Copenhagen Denmark
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Han J, Byun MK, Lee J, Han SY, Lee JB, Han SH. Longitudinal analysis of retinal nerve fiber layer and ganglion cell–inner plexiform layer thickness in ethambutol-induced optic neuropathy. Graefes Arch Clin Exp Ophthalmol 2015; 253:2293-9. [DOI: 10.1007/s00417-015-3150-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Revised: 07/02/2015] [Accepted: 08/21/2015] [Indexed: 11/30/2022] Open
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Chen JJ, Thurtell MJ, Longmuir RA, Garvin MK, Wang JK, Wall M, Kardon RH. Causes and Prognosis of Visual Acuity Loss at the Time of Initial Presentation in Idiopathic Intracranial Hypertension. Invest Ophthalmol Vis Sci 2015; 56:3850-9. [PMID: 26070058 DOI: 10.1167/iovs.15-16450] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To determine the etiology and prognosis of visual acuity loss in idiopathic intracranial hypertension (IIH) at presentation and to provide objective measures to predict visual outcome. METHODS A retrospective review of 660 patients with IIH (2009-2013) identified 31 patients (4.7%) with 48 eyes having best-corrected visual acuity (BCVA) of 20/25 or worse on initial presentation. Fundus photography, optical coherence tomography (OCT) of the optic disc and macula, and perimetry were used to determine the causes and prognosis of vision loss. Segmentation of the macula OCT was performed using the Iowa Reference Algorithm to determine the retinal ganglion cell-inner plexiform layer complex (GCL-IPL) thickness. RESULTS Outer retinal changes alone caused decreased BCVA at initial presentation in 22 eyes (46%): subretinal fluid in 16, chorioretinal folds in 5, and peripapillary choroidal neovascularization in 1. The vision loss was reversible except for some eyes with chorioretinal folds. Optic neuropathy alone caused decreased BCVA in 10 eyes (21%) and coexisting outer retinal changes and optic neuropathy caused decreased BCVA in 16 eyes (33%). A GCL-IPL thickness less than or equal to 70 μm at initial presentation or progressive thinning of greater than or equal to 10 μm within 2 to 3 weeks compared with baseline correlated with poor visual outcome. CONCLUSIONS Visual acuity loss in IIH can be caused by both outer retinal changes and optic neuropathy. Vision loss from outer retinal changes is mostly reversible. The outcome of patients with coexisting outer retinal changes and optic neuropathy or optic neuropathy alone depends on the degree of optic neuropathy, which can be predicted by the GCL-IPL thickness.
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Affiliation(s)
- John J Chen
- Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, Iowa, United States 2Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota, United States
| | - Matthew J Thurtell
- Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, Iowa, United States 3Department of Neurology, University of Iowa, Iowa City, Iowa, United States 4Department of Veterans Affairs, Iowa City, Iowa, United States
| | - Reid A Longmuir
- Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, Iowa, United States 4Department of Veterans Affairs, Iowa City, Iowa, United States
| | - Mona K Garvin
- Department of Veterans Affairs, Iowa City, Iowa, United States 5Department of Electrical and Computer Engineering, University of Iowa, Iowa City, Iowa, United States
| | - Jui-Kai Wang
- Department of Veterans Affairs, Iowa City, Iowa, United States 5Department of Electrical and Computer Engineering, University of Iowa, Iowa City, Iowa, United States
| | - Michael Wall
- Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, Iowa, United States 3Department of Neurology, University of Iowa, Iowa City, Iowa, United States 4Department of Veterans Affairs, Iowa City, Iowa, United States
| | - Randy H Kardon
- Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, Iowa, United States 4Department of Veterans Affairs, Iowa City, Iowa, United States
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Age-Related Vitamin D Deficiency Is Associated with Reduced Macular Ganglion Cell Complex: A Cross-Sectional High-Definition Optical Coherence Tomography Study. PLoS One 2015; 10:e0130879. [PMID: 26090872 PMCID: PMC4474669 DOI: 10.1371/journal.pone.0130879] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 05/26/2015] [Indexed: 01/06/2023] Open
Abstract
Background Vitamin D deficiency is associated with smaller volume of optic chiasm in older adults, indicating a possible loss of the visual axons and their cellular bodies. Our objective was to determine whether vitamin D deficiency in older adults is associated with reduced thickness of the ganglion cell complex(GCC) and of the retinal nerve fibre layer(RNFL), as measured with high-definition optical coherence tomography(HD-OCT). Methods Eighty-five French older community-dwellers without open-angle glaucoma and patent age-related macular degeneration(mean, 71.1±4.7years; 45.9%female) from the GAIT study were separated into 2 groups according to serum 25OHD level(i.e., deficient≤25nmol/L or sufficient>25nmol/L). Measurements of GCC and RNFL thickness were performed using HD-OCT. Age, gender, body mass index, number of comorbidities, dementia, functional autonomy, intracranial volume, visual acuity, serum calcium concentration and season of testing were considered as potential confounders. Results Mean serum 25OHD concentration was 58.4±26.8nmol/L. Mean logMAR visual acuity was 0.03±0.06. Mean visual field mean deviation was -1.25±2.29dB. Patients with vitamin D deficiency(n=11) had a reduced mean GCC thickness compared to those without vitamin D deficiency(72.1±7.4μm versus 77.5±7.5μm, P=0.028). There was no difference of the mean RNFL thickness in these two groups(P=0.133). After adjustment for potential confounders, vitamin D deficiency was associated with reduced GCC thickness(ß=-5.12, P=0.048) but not RNFL thickness(ß=-9.98, P=0.061). Specifically, vitamin D deficiency correlated with the superior medial GCC area(P=0.017) and superior temporal GCC area(P=0.010). Conclusions Vitamin D deficiency in older patients is associated with reduced mean GCC thickness, which can represent an early stage of optic nerve damage, prior to RNFL loss.
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Rönnbäck C, Grønskov K, Larsen M. Retinal vessel diameters decrease with macular ganglion cell layer thickness in autosomal dominant optic atrophy and in healthy subjects. Acta Ophthalmol 2014; 92:670-4. [PMID: 24612963 DOI: 10.1111/aos.12378] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Accepted: 01/29/2014] [Indexed: 11/27/2022]
Abstract
PURPOSE To investigate retinal trunk vessel diameters in subjects with autosomal dominant optic atrophy (ADOA) and mutation-free healthy relatives. METHODS This cross-sectional study included 52 ADOA patients with the optic atrophy 1 (OPA1) exon 28 (c.2826_2836delinsGGATGCTCCA) mutation (age 8.6-83.5 years) (best-corrected visual acuity (BCVA) 8-94 Early Treatment Diabetic Retinopathy Study (ETDRS) letters) and 55 mutation-free first-degree healthy relatives (age 8.9-68.7 years, BCVA 80-99). Analysis of fundus photographs provided integrated magnification-corrected measures of retinal vessel diameters (central retinal artery equivalent, CRAE, and central retinal vein equivalent, CRVE). Statistical analysis was corrected for age, gender, spherical equivalent refraction, axial length and mean arterial blood pressure (MABP) in a mixed model analysis. RESULTS Retinal arteries and veins were thinner in ADOA than in healthy controls (CRAE (mean ± 2 standard deviations (SD)) 153.9 ± 41.0 μm and CRVE 236.1 ± 42.0 μm in ADOA, CRAE 172.5 ± 25.0 μm (p = 0.0004) and CRVE 254.2 ± 37.6 μm (p = 0.0019) in healthy controls). MABP was comparable in the two groups (p = 0.18), and in both groups, CRAE decreased with increasing MABP (p = 0.01 and p < 0.0001, respectively). In ADOA, CRAE and CRVE decreased with age (p = 0.011 and p = 0.020, respectively) and CRAE decreased with decreasing BCVA (p = 0.011). In patients with ADOA and in healthy controls, CRAE decreased with decreasing average macular ganglion cell-inner plexiform layer (GC-IPL) thickness (p = 0.0017 and p = 0.0057, respectively). CONCLUSION Narrow retinal arteries and veins were associated not only with the severity of ADOA but with ganglion cell volume in patients with ADOA and in healthy subjects. This suggests that narrow vessels are a consequence rather than the cause of inner retinal hypoplasia or atrophy, although longitudinal studies are needed to confirm this hypothesis.
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Affiliation(s)
- Cecilia Rönnbäck
- Department of Ophthalmology; Glostrup Hospital; Glostrup Denmark
- Faculty of Health Sciences; University of Copenhagen; Copenhagen Denmark
| | - Karen Grønskov
- Faculty of Health Sciences; University of Copenhagen; Copenhagen Denmark
- Applied Human Molecular Genetics; Kennedy Center; Rigshospitalet; Copenhagen Denmark
| | - Michael Larsen
- Department of Ophthalmology; Glostrup Hospital; Glostrup Denmark
- Faculty of Health Sciences; University of Copenhagen; Copenhagen Denmark
- National Eye Clinic; Kennedy Center; Rigshospitalet; Copenhagen Denmark
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Rebolleda G, Diez-Alvarez L, Casado A, Sánchez-Sánchez C, de Dompablo E, González-López JJ, Muñoz-Negrete FJ. OCT: New perspectives in neuro-ophthalmology. Saudi J Ophthalmol 2014; 29:9-25. [PMID: 25859135 DOI: 10.1016/j.sjopt.2014.09.016] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Accepted: 09/09/2014] [Indexed: 01/03/2023] Open
Abstract
Optical coherence tomography (OCT) has become essential to evaluate axonal/neuronal integrity, to assess disease progression in the afferent visual pathway and to predict visual recovery after surgery in compressive optic neuropathies. Besides that OCT testing is considered a powerful biomarker of neurodegeneration and a promising outcome measure for neuroprotective trials in multiple sclerosis (MS). Currently, spectral-domain OCT (SD-OCT) technology allows quantification of retinal individual layers. The Ganglion Cell layer (GCL) investigation has become one of the most useful tools from a neuro-ophthalmic perspective. It has a high correlation with perimetry, is predictive of future progression and is a highly sensitive, specific of several neuro-ophthalmic pathologies. Moreover the superior correlation with clinical measures compared to peripapillary retinal nerve fiber layer (pRNFL) suggests that GCL analysis might be a better approach to examine MS neurodegeneration. In disorders with optic disk edema, such as ischemic optic neuropathy, papillitis and papilledema, reduction in RNFL thickness caused by axonal atrophy is difficult to distinguish from a swelling resolution. In this setting, and in buried optic nerve head drusen (ONHD), GCL analysis may provide more accurate information than RNFL analysis and it might be an early structural indicator of irreversible neuronal loss. Enhanced depth imaging OCT (EDI-OCT) provides in vivo detail of ONHD, allowing to evaluate and quantify the drusen dimensions. OCT is improving our knowledge in hereditary optic neuropathies. Furthermore, there is growing evidence about the role of OCT as an adjunctive biomarker of disorders such as Alzheimer and Parkinson's disease.
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Affiliation(s)
- Gema Rebolleda
- Hospital Universitario Ramón y Cajal. IRYCIS, Ophthalmology Service, University of Alcala, Madrid, Spain
| | - Laura Diez-Alvarez
- Hospital Universitario Ramón y Cajal. IRYCIS, Ophthalmology Service, University of Alcala, Madrid, Spain
| | - Alfonso Casado
- Hospital Universitario Ramón y Cajal. IRYCIS, Ophthalmology Service, University of Alcala, Madrid, Spain
| | - Carmen Sánchez-Sánchez
- Hospital Universitario Ramón y Cajal. IRYCIS, Ophthalmology Service, University of Alcala, Madrid, Spain
| | - Elisabet de Dompablo
- Hospital Universitario Ramón y Cajal. IRYCIS, Ophthalmology Service, University of Alcala, Madrid, Spain
| | - Julio J González-López
- Hospital Universitario Ramón y Cajal. IRYCIS, Ophthalmology Service, University of Alcala, Madrid, Spain
| | - Francisco J Muñoz-Negrete
- Hospital Universitario Ramón y Cajal. IRYCIS, Ophthalmology Service, University of Alcala, Madrid, Spain
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Barboni P, Savini G, Cascavilla ML, Caporali L, Milesi J, Borrelli E, La Morgia C, Valentino ML, Triolo G, Lembo A, Carta A, De Negri A, Sadun F, Rizzo G, Parisi V, Pierro L, Bianchi Marzoli S, Zeviani M, Sadun AA, Bandello F, Carelli V. Early macular retinal ganglion cell loss in dominant optic atrophy: genotype-phenotype correlation. Am J Ophthalmol 2014; 158:628-36.e3. [PMID: 24907432 DOI: 10.1016/j.ajo.2014.05.034] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Revised: 05/25/2014] [Accepted: 05/27/2014] [Indexed: 12/26/2022]
Abstract
PURPOSE To assess the peripapillary retinal nerve fiber and macular retinal ganglion cell (RGC) loss in patients with dominant optic atrophy (DOA) stratified by OPA1 mutation type. DESIGN Cross-sectional study. METHODS We studied 39 patients from 28 pedigrees with DOA harboring heterozygous mutations in the OPA1 gene along with 45 age-matched healthy subjects. The retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GC-IPL) of patients with DOA were evaluated by optical coherence tomography (OCT) and compared to those of controls. Patients' eyes were divided into 4 groups based on increasing severity of visual loss (DOA1 to DOA4) and were stratified by OPA1 mutation type. RESULTS The average thicknesses of the RNFL and GC-IPL were smaller in patients with DOA than in healthy controls (P < 0.0001). RNFL analysis showed a significant reduction of the average, superior and inferior quadrants thicknesses in the DOA4 group compared to the DOA1 group (P = 0.001, P = 0.002 and P = 0.001, respectively). GC-IPL analysis showed a significant thinning in the superotemporal and superior sectors in the patients with DOA2 compared to those with DOA1 (P = 0.046 and P = 0.04, respectively). Stratifying by mutation type, average, superior and nasal RNFL thinning was significantly more severe in missense mutations and had a presumed dominant-negative effect compared to mutations causing haploinsufficiency. CONCLUSIONS The present study demonstrates that in DOA, loss of macular RGCs is the earliest pathologic event, better reflected by GC-IPL measurements, whereas RNFL thickness is a measure of spared axons in late stages of the disease. Thus, mild cases (DOA2) show significant macular RGC loss as opposed to substantial maintenance of RNFL thickness, which is significantly decreased only in severe cases (DOA4). A clear genotype/phenotype correlation emerged, stratifying OCT measures by OPA1 mutation type, missense mutations being the most severe.
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Affiliation(s)
- Piero Barboni
- Scientific Institute San Raffaele, Milan, Italy; Studio Oculistico d'Azeglio, Bologna, Italy.
| | | | | | - Leonardo Caporali
- Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | | | | | - Chiara La Morgia
- Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy; Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
| | - Maria Lucia Valentino
- Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy; Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
| | | | - Andrea Lembo
- San Giuseppe Hospital, University Eye Clinic, Milan, Italy
| | - Arturo Carta
- Department of Ophthalmology, University of Parma, Italy
| | | | | | - Giovanni Rizzo
- Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy; Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
| | | | | | - Stefania Bianchi Marzoli
- Neuro-ophthalmology Unit Department of Ophthalmology, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) Istituto Auxologico Italiano, Milano, Italy
| | - Massimo Zeviani
- Unit of Molecular Neurogenetics, Foundation C. Besta Neurological Institute, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Milan, Italy; Medical Research Council Mitochondrial Biology Unit, Cambridge, UK
| | - Alfredo A Sadun
- Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | - Valerio Carelli
- Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy; Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
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Yri HM, Rönnbäck C, Wegener M, Hamann S, Jensen RH. The course of headache in idiopathic intracranial hypertension: a 12-month prospective follow-up study. Eur J Neurol 2014; 21:1458-64. [PMID: 25070715 DOI: 10.1111/ene.12512] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Accepted: 05/26/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE Our aim was to prospectively describe the course of headache during the first year of idiopathic intracranial hypertension (IIH). METHODS Patients with newly diagnosed IIH were consecutively included from December 2010 to June 2013. Treatment according to standard guidelines was initiated. Headache history was obtained by headache diaries and standardized interviews performed at baseline and after 1, 2, 3 and 12 months. Parallel changes in papilledema were assessed by optical coherence tomography (OCT). All patients had comprehensive neuro-ophthalmological examinations including automated perimetry. RESULTS Forty-four patients were included. Thirty-five patients completed the 12-month follow-up. Dramatic improvement in headache occurred within the first weeks after diagnosis. After 1 year, 15 patients reported no or only infrequent headache. However, 15 of the remaining 20 patients reported sustained chronic headache. Early age of onset and high diagnostic intracranial pressure (ICP) were associated with better headache outcome (≤1 headache days/month) after a year. Papilledema decreased rapidly within the first 2 months of diagnosis. After 1 year, OCT measures had normalized. Visual outcome was excellent in most patients. CONCLUSIONS Although headache in 43% of patients responded well to ICP management, sustained long-term headache was seen in the remaining patients, despite resolution of papilledema. Headache in IIH may thus be attributed to more complex mechanisms than ICP elevation alone. High ICP and young age were associated with better headache outcome. Early treatment according to standard guidelines seems sufficient to ensure excellent visual outcome in the vast majority of patients.
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Affiliation(s)
- H M Yri
- Danish Headache Center, Department of Neurology, Glostrup Hospital, University of Copenhagen, Glostrup, Denmark
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Abegg M, Zinkernagel M, Wolf S. Re: Rönnbäck et al.: Imaging of the macula indicates early completion of structural deficit in autosomal-dominant optic atrophy (Ophthalmology 2013;120:2672–7). Ophthalmology 2014; 121:e29-30. [DOI: 10.1016/j.ophtha.2013.11.044] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Accepted: 11/19/2013] [Indexed: 11/28/2022] Open
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Mitochondrial dysfunction affecting visual pathways. Rev Neurol (Paris) 2014; 170:344-54. [DOI: 10.1016/j.neurol.2014.03.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Revised: 03/08/2014] [Accepted: 03/26/2014] [Indexed: 01/08/2023]
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Rönnbäck C, Milea D, Larsen M. Author reply: To PMID 24120325. Ophthalmology 2014; 121:e30-1. [PMID: 24582406 DOI: 10.1016/j.ophtha.2013.12.040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Accepted: 12/18/2013] [Indexed: 11/19/2022] Open
Affiliation(s)
- Cecilia Rönnbäck
- Department of Ophthalmology, Glostrup Hospital, Glostrup, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Dan Milea
- Department of Ophthalmology, Glostrup Hospital, Glostrup, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Michael Larsen
- Department of Ophthalmology, Glostrup Hospital, Glostrup, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; National Eye Clinic, Kennedy Center, Glostrup, Denmark
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